等长收缩运动对冠脉完全闭塞患者血内皮祖细胞的影响（英文）

Influence of isometric exercise training on blood endothelial progenitor cells in patients with coronary total occlusion

目的:研究等长收缩运动训练(IE)对冠状动脉慢性完全闭塞(CTO)患者循环血内皮祖细胞(EPCs)和血管内皮生长因子(VEGF)的影响。方法:CTO患者分为训练组(10例)和常规治疗组(对照组,10例),均应用三个月常规药物治疗,其中训练组患者同时进行三个月的IE(采用最大程度握拳诱导上肢肌肉最大等长收缩运动,导致短暂的骨骼肌生理性缺血)训练。采用流式细胞术检测循环血EPCs的数量,ELISA法检测血清VEGF的浓度。结果:治疗前,两组患者循环血EPCs数量和VEGF浓度的差异均无显著性(P>0.05)。与治疗前比较,治疗3个月后,训练组患者血EPCs数量[(0.028±0.009)%比(0.044±0.016)%],VEGF浓度[(65.3±15.1)pg/ml比(98.5±17.4)pg/ml]显著增加(P=0.015,P<0.01),且显著高于常规治疗组治疗后;对照组治疗前后血EPCs数量和VEGF浓度差异均没有显著性(P>0.05)。训练组和对照组患者血EPCs数量与VEGF浓度均呈正相关(r=0.727,r=0.785,P均<0.05)。结论:等长收缩运动训练可以增加冠状动脉慢性完全闭塞患者循环血内皮祖细胞的数量和血管内皮生长因子的浓度,从而可能通过远隔作用促进缺血心肌侧支循环的生成。

Objective： To investigate influence of isometric exercise （IE） training on number of endothelial progenitor cells （EPCs） and level of vascular endothelial growth factor （VEGF） of circulating blood in patients with coronary chronic total occlusion （CTO）. Methods： A total of 20 CTO patients were divided into training group （n= 10） and control group （n= 10）. Both groups received routine medication for three months, training group also received three-month IE training （maximal handgrip was used to induce maximum IE of upper limb muscles, leading to tem- porary physiological ischemia of skeletal muscle）, while control group remained sedentary without exercise training. Flow cytometry was used to measure number of blood EPCs, and enzyme linked immunosorbent assay （ELISA） was used to measure serum concentration of VEGF. Results： Before treatment, the differences of levels of blood EPCs and VEGF between two groups were no significant （P〉0.05）. Compared with before treatment, there were signif-icant increase in blood number of EPCs P （0.028 ± 0. 009） % vs. （0. 044 ± 0.016） % ] and VEGF concentration [ （ 65.3 ±15.1） pg/ml vs. （98.54±17.4） pg/ml] after three-month ti：eatment in training group （P=0. 015, P〈0.01）, and they were significantly higher than those of control group after treatment. Compared with before treatment, there were no significant difference in blood number of EPCs and concentration of VEGF after treatment in control group, P〉0.05. The blood numbers of EPCs were positively correlated with VEGF concentration in training group and control group （r = 0. 727, r = 0. 785, P〈0.05 both）. Conclusion： Isometric exercise training can increase blood number of EPCs and VEGF concentration in coronary CTO patients, which may contribute to collateral angiogenesis in remote ischemic myocardium.